As reported to Adrienne Wald EdD, MBA, RN, MCHES, CNE
There are three important issues that I’m following in this election year. The first is what political candidates—including in gubernatorial races—propose for continuing to improve healthcare coverage for people in the United States.
Nurses need to hold electoral candidates and public officials accountable. If a presidential candidate promises to repeal the Affordable Care Act, we should be asking, “What will you replace it with?” At the state level, not all states adopted Medicaid expansion, but now some governors and gubernatorial candidates of states that did not opt into the expansion are considering it.
The second is the extent to which the nation is moving toward the Triple Aim of improving people’s experiences with care, improving the health of the population, and decreasing per capita healthcare costs. Payment approaches are changing from volume-based to value-based, presenting a great opportunity for nurses to demonstrate the value of nursing care. A growing movement is focusing on a “Quadruple Aim,” with the fourth aim being improving the job satisfaction of healthcare workers. This aim recognizes that healthcare organizations cannot improve the quality, safety, and cost of health care unless they also focus on improving the engagement of employees in decision making, improve employees’ experiences of joy in their work, and reduce and prevent employee burnout.
Finally, nurses must focus more attention on promoting healthy individuals, families, and communities—before health problems develop. The Robert Wood Johnson Foundation has a major initiative on building a culture of health in the United States, and public health advocates are calling for health in all public policies: economic, labor, social, environmental, or otherwise. Nurses can both foster a culture of health and call for local, state, and federal policies that will promote health. Investing in more health care is not what the nation needs. We need to invest in communities to create jobs with a living wage, quality education, safe environments, clean water, fresh and affordable foods, and other health-promoting strategies.
Nursing is the largest and most trusted health profession in this country. But this leverage won’t count if we don’t use our influence. Oncology nurses, in particular, have an opportunity to speak to political candidates about policies and measures that can reduce the incidence of myriad cancers, ensure that patients can receive high-quality health care, and reduce the cost of cancer care. We can also inform the public and educate our patients.